Advance care planning (ACP) is a process through which an individual plans for the care they wish to receive in the future based on their values, beliefs, preferences, and specific medical needs. An advance directive records that process.
Advance care planning is a vitally important task that, unfortunately, is not done by most people. Many people do not want to think about their own death, or the events leading up to it. If this is not done, however, people often receive medical care and interventions that they do not want and that are not beneficial to them. Dr. Joel Policzer shares why beginning advance care planning is so important.
About our Guest Author, Joel Policzer, MD
Joel Policzer, MD, MS, FACP, FAAHPM is the Senior Medical Director for Academic Affairs at VITAS Healthcare, a leading hospice provider across 14 states and DC. Prior to that role, he served as the Senior Vice President, National Medical Director for VITAS. Dr. Policzer earned his Doctor of Medicine from the University of Medicine and Dentistry at the New Jersey Medical School.
What is an Advance Care Plan?
Many people will go to their lawyers and request a Living Will, which is a part of an Advance Directive that often simply states, “If I am terminally ill, do not prolong my life.” This statement is not helpful to medical professionals because that is not how medicine is practiced; it is too simplistic.
At the very least, people must give guidelines as to what their view of their life is, and what compromises they are willing to accept. “If I am in a situation where ‘X’ has occurred, and it is not reversible, then my life is no longer worth living, and I do not want aggressive interventions to keep me alive.”
For example, some people find that needing full-time assistance by an aide for all life activities is unacceptable. Others may say that if they are unable to recognize or interact with children, grandchildren, and friends, that situation is unacceptable.
Why is Early Advance Care Planning Important?
There is evidence that people want to have these conversations and want to have their wishes documented, but often wait for their physicians to bring the subject up. Often though, because of various factors including time constraints, that does not happen until an individual is facing a life-threatening crisis.
There are multiple reasons to begin your advance care planning sooner rather than later. While it can be difficult to begin thinking about your wishes for your care should your health decline, doing so early and returning to it at regular intervals depending on your state of health ensures that you set your future self up to receive the care you’d like to receive.
Advance care planning also alleviates burdens on your loved ones who may otherwise be responsible for your care but uninformed as to your wishes, leaving them to guess and potentially live with concerns that they did not guess correctly.
Here are Some Key ACP Takeaways:
- Discuss your current medical problems and what potential poor outcomes could occur with your physician.
- Decide which functional and mental compromises are acceptable to you, which you could live with long-term, and which are unacceptable to you.
- Write these preferences down and include the name of the person whom you wish to have make decisions for you when you no longer can, using the directive as a guide. We have information on the different types of healthcare documents so you can understand what is available to you.
- Discuss your wishes with that surrogate and other stakeholders in the family.
Resources for Getting Started
Understanding more about the “why” behind the ACP process may inspire you to act. If you’d like to learn more about the forms involved in advance care planning, visit CaringInfo’s Advance Directives section. There, you will also find a downloadable, annotated version of your state or territory’s advance directive form, available in English and Spanish.
If you’d like additional resources to support you in speaking with your physician about your care goals, CaringInfo’s Talking with Your Doctors and Other Healthcare Providers can help.
